Defense Date


Document Type


Degree Name

Doctor of Philosophy


Medical Physics

First Advisor

Martin Murphy


The purpose of this work is to present the development and validation of a novel method for reconstructing time-dependent, or 4D, cone-beam CT (4DCBCT) images. 4DCBCT can have a variety of applications in the radiotherapy of moving targets, such as lung tumors, including treatment planning, dose verification, and real time treatment adaptation. However, in its current incarnation it suffers from poor reconstruction quality and limited temporal resolution that may restrict its efficacy. Our algorithm remedies these issues by deforming a previously acquired high quality reference fan-beam CT (FBCT) to match the projection data in the 4DCBCT data-set, essentially creating a 3D animation of the moving patient anatomy. This approach combines the high image quality of the FBCT with the fine temporal resolution of the raw 4DCBCT projection data-set. Deformation of the reference CT is accomplished via a patient specific motion model. The motion model is constrained spatially using eigenvectors generated by a principal component analysis (PCA) of patient motion data, and is regularized in time using parametric functions of a patient breathing surrogate recorded simultaneously with 4DCBCT acquisition. The parametric motion model is constrained using forward iterative projection matching (FIPM), a scheme which iteratively alters model parameters until digitally reconstructed radiographs (DRRs) cast through the deforming CT optimally match the projections in the raw 4DCBCT data-set. We term our method FIPM-PCA 4DCBCT. In developing our algorithm we proceed through three stages of development. In the first, we establish the mathematical groundwork for the algorithm and perform proof of concept testing on simulated data. In the second, we tune the algorithm for real world use; specifically we improve our DRR algorithm to achieve maximal realism by incorporating physical principles of image formation combined with empirical measurements of system properties. In the third stage we test our algorithm on actual patient data and evaluate its performance against gold standard and ground truth data-sets. In this phase we use our method to track the motion of an implanted fiducial marker and observe agreement with our gold standard data that is typically within a millimeter.


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VCU Theses and Dissertations

Date of Submission

May 2013